title: A pilot study on the prevalence of Acute Mountain Sickness at the Sikh pilgrimage of Hemkund Sahib in the Indian Himalayas.
abstract: BACKGROUND
  Hemkund Sahib is a popular pilgrimage located at 4,330 m in the Garhwal range of the Indian Himalayas. Many travelers to the region have observed pilgrims exhibiting Acute Mountain Sickness (AMS)-like symptoms. However, no systematic study on its prevalence at Hemkund has been conducted.
  
  
  METHODS
  We surveyed 25 adults. AMS rates were determined using a standard Lake Louise Score (LLS). Responses to questions related to awareness of AMS, the perceived difficulty of the trek, and physiological data including arterial oxygen saturation (SpO2) and pulse rate, amongst others, were collected.
  
  
  RESULTS
  Overall prevalence of AMS was 28% (mild AMS 20%, severe AMS 8%). Borg Rating of Perceived Exertion (RPE) was 3.9/10. Water consumption for the 4-5 hour trek to Hemkund was only 0.9 L and 20% of pilgrims consumed no water at all. Nine pilgrims claimed to be aware of AMS although only one had taken prophylactic medication. SpO2 was 82.2 ± 1.2% and pulse rate was 106.5 ± 2.9 bpm (mean ± SEM). There were no differences in non-LLS-related parameters when pilgrims were subdivided by presence or absence of AMS.
  
  
  CONCLUSIONS
  This pilot study has, for the first time, documented the prevalence of AMS amongst pilgrims to Hemkund Sahib in the Indian Himalayas.
authors.affiliation: President, A Thousand Metres Above Foundation, Surrey, British Columbia, Canada.
authors.forename: Inderjeet S
authors.initials: IS
authors.lastname: Sahota
authors.forename: Nidhi S
authors.initials: NS
authors.lastname: Panwar
keywords: Acute Mountain Sickness; Hemkund Sahib; altitude physiology; pilgrimage